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Community Health

Assessment Grand Prairie Service

Area

Health Outcomes

Mortality

Years of Potential Life Lost

Infant Mortality

Very Low Birth Weight Births

Morbidity

Health Factors

Health Risk Behaviors

Violence and Injury Prevention

Injury Mortality

ED Visits for Injuries

High Risk Sexual Behavior HIV/STD Rates

Teen Birth Rate

Alcohol Use Liquor Store Density

Access to Clinical Care

Percent Uninsured

Physician-to-Population Ratio

Emergency Department Use

Quality of Clinical Care

Prevention Quality Indicators

Organizational Model For the

Community Health Dashboard

Demographic Profile Grand Prairie Service Area

• The population of the Grand Prairie Dallas Service

Area is much younger than the county population

with only 7.5% of the population age 65 or older,

compared to 9.3% for the county overall.

• The largest race/ethnic group in the Service Area

population is Hispanics, comprising 46.2% of the

population.

• Grand Prairie has a similar proportion of people

with a high school diploma or more (77.9%)

compared with Dallas County as a whole (77.1%).

2

43,398 773,700

37,255 564,260

82,750 1,009,548

15,575 179,552

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Grand Prairie SA Dallas County

Other Non-Hispanic

Hispanic

Black Non-Hispanic

White Non-Hispanic

45,572 630,531

78,932 1,191,372

40,973 631,857

13,501 252,278

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


65+

45-64

15-44

0-14

Age

Race/

Ethnicity

23,636 363,183

30,665 368,596

52,745 855,342

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


More than HS

HS Diploma

Less than HS

Highest

Educational

Attainment

Source: Nielson/Claritas Pop-Facts 2013 version

Demographic Profile Grand Prairie Service Area

• The Grand Prairie Area has a slightly lower

percentage of families in poverty (13.1%) than

the Dallas County-wide rate (15.1%).

• The Service Area’s per capita income was the

sixth lowest of the 13 service areas.

• This Service Area’s percent unemployed is

ranked 5th out of the 13 service areas.

3

37,557 504,918

5,669 89,788

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


below poverty

above poverty

Poverty

Status

(Families)

$19,560

$24,858

$0

$5,000

$10,000

$15,000

$20,000

$25,000

$30,000


PerCapitaIncome

Source: Nielson/Claritas Pop-Facts 2013 version

8.4% 9.5%

10.0% 10.9%

7.0% 8.4%

6.5% 7.5%

15.9%

11.2%

10.1% 8.9%

7.1%

0.0%

5.0%

10.0%

15.0%

20.0%

Percent Unemployed in the Civilian Labor Force

Access to care


Percent Uninsured



Access to Healthcare: Percent Without

Healthcare Insurance Grand Prairie Service Area

5

10%

18% 19%

21%

18% 22%

10%

11%

43%

28%

33%

24%

19% 22%

23%

8%

15% 18%

18%

17% 19%

9% 9%

44%

27%

31%

20% 17%

31% 28%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Ced

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Da

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Da

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1

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Dalla

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Da

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NE

So

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Da

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SE

Da

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SW

Da

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/Se

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Percent Uninsured

2012 2006

Source: 2006 Solucient, Inc.; 2012 Truven Analytics, Inc. Denominator population data from Claritas, Inc.; Texas rate

from US Census Bureau’s American Community Survey 2011

Healthy People 2020 Goal – 0% uninsured

17.9%

18.0%

17.6%

18.0%

18.4%

20.6%

20.8%

18.5%

0.0% 10.0% 20.0% 30.0%

2004

2005

2006

2007

2008

2009

2010

2012

Percent Without Health

Insurance, Grand Prairie

Service Area

Access to Healthcare: Primary Care

Physician-to-Population Ratio Grand Prairie Service Area

6

2012 2004

38.4

21.1

21.2

13.0

23.5

0.0 10.0 20.0 30.0 40.0 50.0

2004

2006

2008

2010

2012

Primary Care Physician-to-

Population Ratio, per 100,000,

Grand Prairie Service Area

Source: Texas Medical Association Physician Practice Address files; denominator population data from

Claritas, Inc., except 2010 from Nielson/Claritas, Inc. Pop Facts. Mid 2010 version.

County and State source is Texas Bureau of Primary Care.

39.5 49.9

23.5

49.6

223.6

106.2

131.1

67.6 44.7

41.0 41.3

142.6

8.5

83.4

69.5

23.1

66.1

38.4

54.4

120.9 112.6

71.3 59.8

40.3

55.6 57.1

134.4

9.3

79.2 68.1

0

50

100

150

200

250

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Da

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Primary Care Physicians per 100,000

Access to Healthcare: Non-

Emergent ED Utilization Grand Prairie Service Area

7

51.2

56.2

63.8

64.6

0.0 20.0 40.0 60.0 80.0

2009

2010

2011

2012

Rate of Non-Emergent ED

Visits, per 1,000, Grand

Prairie Service Area

61.6

77.6

64.6

94.0

53.5

108.5

49.5

55.1

154.3

102.5

94.2

73.2 68.9

82.6

20.4 19.7

23.2 33.5

17.1

38.9

15.8 17.6

53.7

36.5 31.1

19.8

29.1

34.7

0.0

20.0

40.0

60.0

80.0

100.0

120.0

140.0

160.0

180.0

Ced

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So

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Da

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Da

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Da

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So

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Da

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Da

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Dalla

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Non-Emergent ED Visits, per 1,000 Population

2012 2006

Source: DFWHC, Outpatient Data System; NYU Algorithm for determining appropriate Emergency Dept. Use;

denominator population data from Claritas, Inc.

Access to Care


Percent Uninsured



Grand Prairie

Compared to

Healthy

People 2020

Goal

Grand Prairie

Compared to

Other Service

Areas

(Quartiles)

Grand Prairie

Compared to

Past Years’

Data (CI)

N/A

N/A

– Doing better than the benchmark

– Same as/not significantly different from the benchmark

– Worse than the benchmark

Quality of care


Prevention Quality

Indicators

Diabetes-Related

Cardiovascular

Acute/Infectious

Chronic Pulmonary

Healthcare Quality: Rate of Preventable

Hospitalizations, 2011

Diabetes-Related Hospitalizations Grand Prairie Service Area

10

64.1 72.9

59.4 59.9

38.5

79.6

39.1 45.5

129.7

104.6

73.3 49.0

64.8 67.9

0.0

50.0

100.0

150.0

200.0

Diabetes Short Term Complications, 2011

135.4 140.4

109.9

134.9

71.2

153.0 74.6

71.3

226.6 196.8

193.0

131.1 142.7

134.0

0.050.0

100.0150.0200.0250.0300.0

Diabetes Long Term Complications, 2011

9.3

20.9

14.2 15.5

7.2 15.2

5.8 6.6

35.0

20.1

29.2

12.2

21.3 15.5

0.0

10.0

20.0

30.0

40.0

50.0

Uncontrolled Diabetes, 2011

19.6 18.6

15.5

24.8

5.7 14.9

6.3 7.5

36.3

19.4

25.5

8.3 12.7 15.4

0.0

10.0

20.0

30.0

40.0

50.0

Lower Extremity Amputation Among Diabetics, 2011

Source: Texas Department of State Health Services, Texas Health Care Information Council, unpublished data;

denominator population data from US Census American Community Survey



Cardiovascular Disease Hospitalizations Grand Prairie Service Area

11

199.5

330.3 282.8

204.0 179.1

240.7

181.6 190.2

495.6

328.0 304.8

211.3

339.4

263.4

0.0100.0200.0300.0400.0500.0600.0

Congestive Heart Failure, 2011

53.3

79.4 64.7

50.6 36.5

48.1 44.1 43.2

145.7

80.1 72.6

43.4 54.7

62.4

0.0

50.0

100.0

150.0

200.0

Hypertension, 2011

3.3 4.4

3.5

6.7

4.4 5.7

2.6

5.4

3.3

7.7

2.8 1.8

4.3 4.6

0.0

2.0

4.0

6.0

8.0

10.0

Angina Without Cardiac Procedure, 2011





Acute/Infectious Disease Hospitalizations Grand Prairie Service Area

12

187.5

179.6 210.9

220.6

143.7

211.3

144.6 159.6

184.1 206.3

172.7

154.5

252.7

181.7

0.0

100.0

200.0

300.0

400.0

500.0

Bacterial Pneumonia, 2011

138.6 105.8

70.4 95.0

61.9 75.3

78.4

72.9

105.0

84.9 108.6

81.7

102.9 85.4

0.0

50.0

100.0

150.0

200.0

Dehydration, 2011

124.2 138.8

164.5 170.0

114.9

197.4

141.4 147.9

150.7

153.1

167.4 127.6

119.3 149.2

0.0

100.0

200.0

300.0

400.0

Urinary Tract Infection, 2011





Chronic Pulmonary Disease Hospitalizations Grand Prairie Service Area

13

120.6 198.1

200.7 250.9

111.2 198.2

121.5

181.0

312.8 300.7

174.2 124.0

399.0

201.4

0.0

100.0

200.0

300.0

400.0

500.0

Chronic Obstructive Pulmonary Disease, Adults Ages 40+, 2011

7.7

34.4

11.4 9.9

11.4 11.2

8.2 10.3

29.3 18.8

11.4 4.2

7.9 13.2

0.010.020.030.040.050.060.0

Adult Asthma, Adults Under Age 40, 2011



Healthcare Quality Grand Prairie

Compared to

12 Other

Service

Areas

(Quartiles)

Grand Prairie

Compared to

Past Years’

Data (Percent

Change vs.

2010)




Quality of

Clinical Care

Prevention Quality

Indicators

Diabetes ST Comp

Diabetes LT Comp

Uncontrolled Diabetes

Lower Extremity Amputations Among Diabetics

Congestive Heart Failure

Hypertension

Angina Without Cardiac Procedure

Bacterial Pneumonia

Dehydration

Urinary Tract Infection

Chronic Obstructive Pulmonary Disease

Adult Asthma

Health Risk

Behaviors


Injury Prevention

Mortality

ED Use

High Risk Sexual Behavior

HIV/STD’s

Teen Birth Rate


Risk Factors: Auto Accident

Mortality Rates Grand Prairie Service Area

16

Auto Accident Mortality Rate,

Age-Adjusted Death Rate per

100,000, Grand Prairie Service

Area

26.5

11.1

8.5 7.2

6.5

10.6

5.3 5.1

12.9 11.7

6.2 6.4

2.8

8.4

14.1

12.3

15.5

11.4

8.0

11.1

9.0

12.6

11.4

16.2 16.2

18.7

20.9

14.4

17.1

0.0

5.0

10.0

15.0

20.0

25.0

30.0

Ced

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Da

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Da

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Da

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Da

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Da

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Age-Adjusted Deaths per 100,000

2011 2004

Source: Texas Department of State Health Services, Bureau of Vital Statistics; denominator population data from US

Census American Community Survey.

Healthy People 2020 Goal 12.4

15.5

10.2

9.1

12.6

9.9

3.5

8.8

8.5

0.0 5.0 10.0 15.0 20.0

2004

2005

2006

2007

2008

2009

2010

2011

Risk Factors: Accidental Poisoning


17

Accidental Poisoning Mortality

Rate, Age-Adjusted Death Rate

per 100,000, Grand Prairie

Service Area

3.4

5.9

4.2

5.7

11.4

9.9

6.8

7.9

9.0

13.2

9.2

13.5

5.7

9.1

1.3

7.5

5.5 5.9

5.1

2.3

4.5

5.9

13.2

8.6

4.3

6.1

7.8

6.4 6.6

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

16.0

Ced

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Da

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Da

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Da

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Da

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2011 2004




5.5

4.0

3.5

6.7

1.9

2.8

2.9

4.2

0.0 2.5 5.0 7.5

2004

2005

2006

2007

2008

2009

2010

2011

Risk Factors: Accidental Falls


18

Accidental Falls Mortality Rate,



Area

13.0

9.0

4.7

5.2

8.8 9.4

6.7

7.9

3.4

4.9

4.5

3.3

6.1

6.5

0.0

6.6

4.9

8.4

6.2

9.9

2.5

7.7

3.2 3.6

4.9

6.8

8.9

6.6 6.5

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

Ced

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So

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Da

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Da

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Da

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Da

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Da

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2011 2005




4.9

5.2

4.3

4.7

3.5

5.5

4.7

0.0 2.0 4.0 6.0

2005

2006

2007

2008

2009

2010

2011

Risk Factors: Falls Death Rates

Among Seniors Grand Prairie Service Area

19

33.9

20.5

19.3

26.5

24.8

34.9

25.8

0.0 10.0 20.0 30.0 40.0

2005

2006

2007

2008

2009

2010

2011

Falls fatality rates, ages 65+,


Service Area 69.3

74.2

25.8

42.0

61.4

60.8

48.7

57.3

10.2

31.6

32.7

29.1

43.8 43.9

0.0

42.6

33.9

43.7 47.9

61.5

15.0

49.6

17.4 20.2

38.8

48.7

55.6

42.4 42.1

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

Ced

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No

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Da

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Falls Deaths Age 65+

2011 2005


Source: Texas Department of State Health Services, Bureau of Vital Statistics, unpublished data; denominator population data

from US Census Bureau American Community Survey. 2005 Dallas County data from Centers for Disease Control and

Prevention, National Center for Health Statistics. Multiple Cause of Death File 2005-2006. CDC WONDER On-line Database,

compiled from Multiple Cause of Death File 2005-2006Series 20 No. 2L, 2012. Accessed at http://wonder.cdc.gov/mcd-icd10.html

on Mar 25, 2010 2:52:15 PM; 2005 Texas data from http://soupfin.tdh.state.tx.us/

http://wonder.cdc.gov/mcd-icd10.html



http://soupfin.tdh.state.tx.us/

Risk Factors: Rate of Injury-

Related ED Visits Grand Prairie Service Area

20

Rate of Injury-Related ED

Visits, per 1,000, Grand


59.1

64.3

61.4

80.2

48.0

78.7

49.7

58.1

97.0

72.8

62.6

44.8

58.6

64.4

45.8

35.3

56.8

74.3

42.7

63.6

37.1 38.1

73.6

64.4

53.0

36.8

65.3

53.6

0.0

20.0

40.0

60.0

80.0

100.0

120.0

Ced

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Se

ag

Dalla

s C

ou

nty

Rate of Injury-Related ED Visits

2012 2006

56.8

53.7

46.2

50.3

52.4

61.2

61.4

0.0 25.0 50.0 75.0

2006

2007

2008

2009

2010

2011

2012

Source: DFWHC ERF Information Quality Services Center Regional Data, 2012. Dallas-Fort Worth Hospital Council

Education and Research Foundation, Information and Quality Services Center, Irving, Texas. July 2013.

Denominator population data from Claritas, Inc.


Risk Factors: Suicide


21

Suicide Mortality Rate, Age-

Adjusted Death Rate per 100,000,

Grand Prairie Service Area 15.4 15.3

8.5

7.2

13.4

11.3

10.6

6.9

2.5

7.6

4.2

13.7

10.8

9.3 8.3

6.5

9.7 11.0

14.1

5.7

15.1

7.0 7.1 7.7

5.3

6.7

8.6

9.5 10.6

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

16.0

18.0

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Dalla

s

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Dalla

s

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Te

xa

s


2011 2004




9.7

7.6

2.8

8.1

3.2

5.5

5.9

8.5

0.0 3.0 6.0 9.0 12.0

2004

2005

2006

2007

2008

2009

2010

2011

Risk Factors: Homicide


22

Homicide Mortality Rate, Age-



1.4

14.7

6.2

4.7

2.7

5.1

3.8

2.9

16.5

12.6 11.1

3.9

2.6

6.7 7.0 8.6 9.3

6.3 7.1 6.2

2.8

4.5

40.4

14.7

20.0

7.2

4.9

11.3

6.1

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Dalla

s

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Dalla

s

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Te

xa

s


2011 2004




9.3

8.4

2.6

5.2

5.9

3.3

1.1

6.7

0.0 2.5 5.0 7.5 10.0

2004

2005

2006

2007

2008

2009

2010

2011

Risk Factors: High Risk Sexual Behavior, Sexually

Transmitted Disease Incidence Rates, 2011 Grand Prairie Service Area

23

644.3 853.0

471.3

587.5

451.5

558.3 342.1

254.2

1,422.4

810.6 773.4

950.5

493.7 648.3

417.4

-

500.0

1,000.0

1,500.0

2,000.0

Chlamydia Incidence per 100,000

215.2

273.5

108.0 121.0

141.7

163.5

83.2 76.8

546.1

267.6

197.0

292.4

128.7

198.0

115.7

- 100.0 200.0 300.0 400.0 500.0 600.0 700.0

Gonorrhea Incidence per 100,000

7.8 5.4 4.1

2.9 4.1

6.5 4.3

3.1

15.3

6.4 9.1

14.5

1.5

6.6 6.6

-

5.0

10.0

15.0

20.0

Primary & Secondary Syphilis Incidence per 100,000

23.5 25.1

11.7 17.4

40.4 31.9

26.5 16.5

62.3

29.1 30.3

92.1

23.9 34.8

17.5

-

20.0

40.0

60.0

80.0

100.0

120.0

New HIV Incidence per 100,000

Source: Texas Department of State Health Services, Bureau of STD/HIV, unpublished data; denominator population data from Claritas, Inc.; Dallas

County and Texas Rates are from http://www.dshs.state.tx.us/hivstd/reports/STD2011.pdf and http://www.dshs.state.tx.us/hivstd/reports/HIV2011.pdf

Risk Factors: High Risk Sexual

Behavior, Teen Birth Rates Grand Prairie Service Area

24

Teen Births, Rate Per 1,000 Girls

Ages 15-17, Grand Prairie

Service Area

18.1 16.5

22.1

38.7

15.9

34.3

15.9

13.7

47.3

40.4

45.8

32.5

29.5

30.3

20.1

24.3

36.5

57.5

31.4

44.4

19.0 16.6

67.8

47.6

62.7

55.1

35.7

42.0

-

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Da

llas

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Da

llas

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Teen Birth Rate

2011 2005

Source: Texas Department of State Health Services, Bureau of Vital Statistics; denominator population data

Nielson/Claritas mid 2011 Pop Facts

36.5

40.6

32.9

30.3

32.3

24.9

22.1

0.0 25.0 50.0

2005

2006

2007

2008

2009

2010

2011


Risk Factors: Liquor Store

Density, 2011 Grand Prairie Service Area

25

1.3 2.4

1.8

6.3

12.3 8.9

8.8

3.1

20.8

5.9 3.8

33.4

4.2

9.0 6.9

2.8

0.0 2.0

0.0

14.7

8.9 8.7

4.0

14.2

10.4

1.9

48.6

0.0

9.3 7.1

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

50.0

55.0

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Dalla

s

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Te

xa

s

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Dalla

s

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Te

xa

s

Liquor Stores Per 100,000, 2011

Source: US Census Bureau, 2011 County Business Patterns; denominator population data from US Census Bureau; 2007 from US Census

Bureau, 2007 Economic Census; denominator population data from Claritas, Inc.; Dallas County and State of Texas data from US Census

Bureau, NIACS annual business estimates

7.2

7.4

6.9

7.1

7.0

6.9

0.0 2.5 5.0 7.5 10.0

2004

2005

2006

2007

2008

2011

Liquor Store Density, Stores per

100,000, State of Texas

2011 2007


Grand

Prairie

Compared

to Healthy

People

2020 Goal

Grand Prairie

Compared to

Other Service

Areas

(Quartiles)

Grand

Prairie

Compared

to Past

Years’

Data (CI)




Health Risk

Behaviors

Injury Prevention

Motor Vehicle Crash Death Rate

Accidental Poisoning Death Rate

Accidental Falls Death Rate

Senior Falls Death Rate

Suicide Death Rate

Homicide Death Rate

Emergency Department Injury Visits


Grand

Prairie

Compared

to Healthy

People

2020 Goal

Grand Prairie

Compared to

Other Service

Areas

(Quartiles)

Grand

Prairie

Compared

to Past

Years’ Data

(CI)

N/A

N/A

N/A

N/A

N/A N/A




Health Risk

Behaviors

High Risk Sexual

Behavior

Teen Birth Rate

Chlamydia Incidence Rate

Gonorrhea Incidence Rate

Syphilis Incidence Rate

HIV Incidence Rate

Alcohol Use

Liquor Store Density

Health Outcomes

Mortality

Heart Disease

Cancer

Cerebrovascular Disease


Diabetes Mellitus

Years of Potential Life

Lost

Infant Mortality

Low Birth Weight Births

Communicable Disease Morbidity

Aseptic Meningitis

Cryptosporidiosis

Pertussis

Salmonellosis

Health Outcomes

Health Outcomes: Heart Disease


29

Heart Disease Mortality Rate, Age-



227.4

220.8

139.2

187.9

150.4

194.0

142.2 144.3

244.9

216.6

192.8

139.0

222.2

179.1

138.1

191.8

218.1

198.6

164.6

197.0

149.4

174.4

323.2

252.9 240.8

188.3

285.9

229.2

224.5

0.0

50.0

100.0

150.0

200.0

250.0

300.0

350.0

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Dalla

s

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Dalla

s

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Te

xa

s


2011 2004


Census American Community Survey


218.1

195.9

193.5

155.7

156.5

132.4

145.1

139.2

0.0 100.0 200.0 300.0

2004

2005

2006

2007

2008

2009

2010

2011

Health Outcomes: Cancer


30

Cancer Mortality Rate, Age-



212.3 213.2

132.7

187.7

140.9

158.5

133.9

150.2

214.4

191.7

206.5

135.7

205.0

168.8 173.0

229.6

165.9

202.4

148.6

145.8

147.9

141.9

253.1

182.7

176.7

151.6

186.8 187.6

181.4

0.0

50.0

100.0

150.0

200.0

250.0

300.0

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Dalla

s

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Dalla

s

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Te

xa

s


2011 2004




165.9

179.5

131.2

138.3

129.6

114.8

129.8

132.7

0.0 100.0 200.0

2004

2005

2006

2007

2008

2009

2010

2011

Health Outcomes: Cerebrovascular

Disease Mortality Rates Grand Prairie Service Area

31

Cerebrovascular Disease

Mortality Rate, Age-Adjusted

Death Rate per 100,000, Grand


60.6

37.1

30.5

44.0

44.5 44.0

44.5

33.7

52.9

44.3

48.1

44.5

32.9

43.2

80.5

64.1 66.1

62.8

48.2

57.7

46.0 43.5

80.5

58.8

65.0

43.8

87.7

63.0

56.2

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Dalla

s

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Dalla

s

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Te

xa

s


2011 2004




66.1

36.1

57.9

32.0

45.7

33.6

37.3

30.5

0.0 25.0 50.0 75.0

2004

2005

2006

2007

2008

2009

2010

2011

Health Outcomes: Chronic Obstructive

Pulmonary Disease Mortality Rates Grand Prairie Service Area

32

Chronic Obstructive Pulmonary

Disease Mortality Rate, Age-



61.2

52.2

34.9

49.8

29.9

44.0

33.4

36.3 36.1

48.4

33.6 34.0

89.9

39.9

58.9

33.6

47.2

36.4

27.2

41.6

35.2 31.2

27.9

44.6

30.0 26.9

72.6

38.9 41.7

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Dalla

s

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Dalla

s

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Te

xa

s


2011 2004



NOTE: No Healthy People 2020 goal

matches this metric.

47.2

25.9

26.1

38.6

38.2

28.7

33.5

34.9

0.0 20.0 40.0 60.0

2004

2005

2006

2007

2008

2009

2010

2011

Health Outcomes: Diabetes


33

Diabetes Mellitus Mortality Rate,


100,000, Grand Prairie Service Area

32.3

24.8

16.7 18.7

12.9

20.6

13.0 13.1

40.5

26.1

32.6

13.4

29.8

20.9

37.0

23.5

19.0 16.8

10.9

18.4

17.8

12.6

36.6

26.2

32.4

16.3

32.7

22.9

29.6

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Dalla

s

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Dalla

s

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Te

xa

s


2011 2004



19.0

24.6

24.8

24.3

11.6

8.6

13.6

16.7

0.0 10.0 20.0 30.0

2004

2005

2006

2007

2008

2009

2010

2011

NOTE: No Healthy People 2020 goal

matches this metric.

Health Outcomes: Birth Outcomes,

Rate of Very Low Birth Weight Births Grand Prairie Service Area

34

Very Low Birth Weight Rate, Percent

of Births Below 1500 Grams at Birth,


2.1%

2.2%

1.9%

1.6%

1.1%

1.7%

1.8%

1.6%

2.4%

1.8%

1.5%

1.7%

2.2%

1.7%

2.4%

2.4%

1.8%

1.5%

1.7%

1.8%

1.2%

1.3%

2.4%

1.5%

1.7%

1.1%

1.3%

1.6% 1.5%

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

Cedar

Hill

DeS

oto

Lanc

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Dalla

s

Oute

r N

E

South

Dalla

s

SE

Dalla

s

SW

Da

llas

Ste

mm

on

s C

orr

Wilm

er

Hutc

h S

eag

Dalla

s C

ounty

Texas

Cedar

Hill

DeS

oto

Lanc

Gra

nd

Pra

irie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Dalla

s

Oute

r N

E

South

Dalla

s

SE

Dalla

s

SW

Dalla

s

Ste

mm

on

s C

orr

Wilm

er

Hutc

h S

eag

Dalla

s C

ounty

Texas

Teen Birth Rate

Healthy People 2020 Goal 1.4%

2011 2005

Source: Texas Department of State Health Services, Bureau of Vital Statistics

1.8%

2.4%

1.6%

1.6%

1.9%

1.5%

1.9%

0.0% 1.0% 2.0% 3.0%

2005

2006

2007

2008

2009

2010

2011

Health Outcomes: Birth Outcomes,

Infant Mortality Rate Grand Prairie Service Area

35

Infant Mortality Rate, Deaths

per 1,000 Live Births, Grand


8.5

6.4

11.5

5.7

4.9

6.1 6.4

5.8

12.9

7.2 7.3

8.3 7.6

7.4 7.6

6.4 7.0

6.4

7.9

7.2

8.6

5.0 5.0

11.2

6.7

8.4

3.2

3.9

7.1

6.5

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

Cedar

Hill

DeS

oto

Lanc

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Dalla

s

Oute

r N

E

So

uth

Da

llas

SE

Dalla

s

SW

Dalla

s

Ste

mm

ons C

orr

Wilm

er

Hutc

h S

eag

Dalla

s C

ounty

Texas (

2010

)

Cedar

Hill

DeS

oto

Lanc

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Dalla

s

Oute

r N

E

So

uth

Da

llas

SE

Da

llas

SW

Dalla

s

Ste

mm

ons C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ounty

Texas

Infant Mortality Rate


2011 2005

Source: Texas Department of State Health Services, Bureau of Vital Statistics

6.4

9.4

8.0

6.0

6.4

11.0

11.5

0.0 2.5 5.0 7.5 10.0 12.5

2005

2006

2007

2008

2009

2010

2011

Health Outcomes: Years of Potential

Life Lost, All Causes Grand Prairie Service Area

36

5,733

5,163

6,150

4,713

4,324

4,389

5,350

0 2,500 5,000 7,500

2005

2006

2007

2008

2009

2010

2011


Rate*, per 100,000, Grand


*Years of Potential Life Lost

Rate is defined as the rate of

deaths under age 75 per 100,000

population under age 75.

6,791

9,500

5,350

6,548

4,648

6,744

5,005

4,626

11,770

8,161

7,455

5,700

6,539

6,851

6,169

8,271

5,733

6,625

5,075

6,921

3,960

4,862

13,958

9,149

8,806

5,518

7,509 7,443

-

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Dalla

s

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Dalla

s

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Years of Potential Life Lost Rate per 100,000*

2011 2005

Source: Texas Department of State Health Services, Bureau of Vital Statistics;

Denominator population data from Claritas, Inc.

Health Outcomes: Estimated Diabetes Prevalence

Rates (Diagnosed and Undiagnosed) Grand Prairie Service Area

37

11.3%

12.6% 11.8% 11.7%

8.9%

11.6%

8.8% 9.2%

16.9%

13.2%

14.8%

12.2% 11.6% 11.8%

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

16.0%

18.0%

Ce

da

r H

ill

DeS

oto

Lanc

Gra

nd

Pra

irie

Irvin

g

No

rth

Dalla

s

NE

Da

llas

NW

Da

llas

Ou

ter

NE

Sou

th D

alla

s

SE

Da

llas

SW

Da

llas

Ste

mm

ons C

orr

Wilm

er

Hu

tch

Se

ag

Da

llas C

oun

ty

Diabetes Prevalence, percent

Source: US Diabetes Index, National Minority Quality Forum and Centers for Disease Control and Prevention, 2012; based on NHANES

population prevalence estimates, 2010. Denominator population data 2010 from Nielson/Claritas, Inc. Pop Facts. Mid 2010 version

Health Outcomes: Reportable

Communicable Disease Rates Grand Prairie Service Area

38

20.91

14.08

9.52

4.37

2.38

0.0 10.0 20.0 30.0

2005

2006

2007

2008

2009

Aseptic Meningitis Incidence

Rate, per 100,000, Grand


2009 2005

10.59

14.74

2.38

5.81

8.97

11.30 11.12

7.01

16.84

15.76

13.24

6.28 7.81

10.49

30.10

29.45

20.91

15.31 15.40

16.33

15.51

7.96

43.35

21.72

38.12

11.85

12.36

22.01

0.00

5.00

10.00

15.00

20.00

25.00

30.00

35.00

40.00

45.00

50.00

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

No

rth D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Da

llas

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

No

rth D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Da

llas

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Aseptic Meningitis Incidence, per 100,000

Source: Texas Department of State Health Services, Infectious Disease Control Unit, unpublished data; denominator population

data from Claritas, Inc.; 2005 Dallas County data from Dallas County Health and Human Services web site:

http://www.dallascounty.org/department/hhservices/services/communicable/documents/ReportableConditions2003-07Annual.pdf;

2005 Dallas County denominator population data from American Community Survey.

http://www.dallascounty.org/department/hhservices/services/communicable/documents/ReportableConditions2003-07Annual.pdf





39

1.61

0.70

0.68

13.10

1.19

0.0 5.0 10.0 15.0

2005

2006

2007

2008

2009

Cryptosporidiosis Incidence

Rate, per 100,000, Grand


2009 2005

1.32

1.13 1.19

0.73

1.17

1.46

1.33

0.39

2.59

0.55

0.47

1.14

0.00

1.06

0.00 0.00

1.61

0.73

0.39

1.09

1.83

0.42

0.00

0.56 0.50

0.59

0.00

0.79

0.00

0.50

1.00

1.50

2.00

2.50

3.00

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Da

llas

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Da

llas

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Cryptosporidiosis Incidence, per 100,000









Communicable Disease Rates


40

7.24

2.11

7.48

4.99

11.29

0.0 5.0 10.0 15.0

2005

2006

2007

2008

2009

Pertussis Incidence Rate, per


Area

2009 2005

5.30

4.54

11.29

10.17

6.63

6.20 5.78

6.23 6.48

7.19

8.98

5.14

3.12

6.94

4.30

6.40

7.24 7.29

7.50

7.26

5.93

12.15

6.37

10.44

12.87

11.85

5.30

9.40

0.00

2.00

4.00

6.00

8.00

10.00

12.00

14.00

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Da

llas

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

Nort

h D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Da

llas

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Pertussis Incidence, per 100,000

Source: Texas Department of State Health Services, Infectious Disease Control Unit, unpublished data; denominator population data

from Claritas, Inc.; 2005 Dallas County data from Dallas County Health and Human Services web site:








41

9.65

6.33

12.24

9.98

5.94

0.0 5.0 10.0 15.0

2005

2006

2007

2008

2009

Salmonellosis Incidence Rate,


Service Area

2009 2005

11.92

11.34

5.94

15.98

10.14

9.48 9.34

11.68

12.95

11.33

10.87

11.41

6.24

11.27

4.30

11.52

9.65 9.48

5.13

6.53

7.76

9.22

6.37

7.62 8.42

8.89 8.83

8.56

0.00

2.00

4.00

6.00

8.00

10.00

12.00

14.00

16.00

18.00

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

No

rth D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Dalla

s

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Ced

ar

Hill

DeS

oto

Lan

c

Gra

nd P

rair

ie

Irvin

g

No

rth D

alla

s

NE

Dalla

s

NW

Da

llas

Ou

ter

NE

So

uth

Da

llas

SE

Da

llas

SW

Dalla

s

Ste

mm

on

s C

orr

Wilm

er

Hu

tch

Se

ag

Dalla

s C

ou

nty

Salmonellosis Incidence, per 100,000









Health Outcomes

Grand

Prairie

Compared

to Healthy

People 2020

Goal

Grand Prairie

Compared to

Other

Service

Areas

(Quartiles)

Grand

Prairie

Compared

to Past

Years’ Data

(CI)

N/A

N/A




Health Outcomes

Mortality

Heart Disease Death Rate

Cancer Death Rate

Cerebrovascular Disease Death Rate


Death Rate

Diabetes Death Rate

Health Outcomes

Grand

Prairie

Compared

to Healthy

People

2020 Goal

Grand

Prairie

Compared

to Other

Service

Areas

(Quartiles)

Grand

Prairie

Compared

to Past

Years’

Data (CI)

N/A

N/A

N/A

N/A




Health Outcomes

Infant Mortality Rate

Very Low Birth Weight Birth Rate

Years of Potential Life Lost Rate

Communicable Disease Morbidity

Aseptic Meningitis Incidence Rate

Cryptosporidiosis Incidence Rate

Pertussis Incidence Rate

Salmonellosis Incidence Rate

Health Outcomes

Mortality


Infant Mortality

Very Low Birth Weight Births

Morbidity

Health Factors


Violence and Injury Prevention

Injury Mortality

ED Visits for Injuries

High Risk Sexual Behavior HIV/STD Rates

Teen Birth Rate



Percent Uninsured




Prevention Quality Indicators

Summary – Model With

Stoplight Pie Charts,


Deviations from the Dallas County mean

Outer Northeast

Northwest Dallas

North Dallas

Irving

Northeast Dallas

Grand Prairie

Wilmer Hutchins Seagoville

Stemmons Corridor

Cedar Hill

Southwest Dallas

DeSoto Lancaster

Southeast Dallas

South Dallas

Mortality VLBW High Risk Sexual BehaviorSocioeconomic YPLL MorbidityAccess to Clinical Care Infant Mortality Violence and InjuryPreventable Hospitalizations

Percent Difference from the Dallas County Average

More Unfavorable More Favorable

NOTE: All data are from the years

2009-2012, years available varies

by topic.

Each vertical line

represents 100%

difference from the

Dallas County average.

Methods of calculating deviations from the

Dallas County mean for the preceding chart

• Mortality. For each service area and for Dallas County, add the 2011 age-adjusted death rates per 100,000 for the five leading causes of death, to

get a single number. Calculate for each service area the percent deviation from the Dallas County total, from -infinity to +infinity. That deviation is

the mortality deviation for the chart. Because heart disease and cancer predominate, this tends to over-weight these two causes compared to the

other three (stroke, COPD and diabetes).

• Years of potential life lost. Using the Years of Potential Life Lost Rate per 100,000, calculate for each service area the percent deviation from the

Dallas County YPLL rate, from -infinity to +infinity. That deviation is the YPLL deviation for the chart.

• Infant Mortality. Using the Infant mortality rate per 1,000 live births, calculate for each service area the percent deviation from the Dallas County

infant mortality rate, from -infinity to +infinity. That deviation is the infant mortality deviation for the chart.

• Very Low Birth Weight. Using the Very Low Birth Weight rate per 1,000 live births, calculate for each service area the percent deviation from the

Dallas County VLBW rate, from -infinity to +infinity. That deviation is the VLBW deviation for the chart.

• Morbidity. For each service area and for Dallas County, add the 2009 incidence rates per 100,000 for the four reportable diseases (aseptic

meningitis, cryptosporidiosis, pertussis, salmonellosis), to get a single number. Calculate for each service area the percent deviation from the

Dallas County total, from -infinity to +infinity. That deviation is the morbidity deviation for the chart. Meningitis and salmonellosis are more

common, so this tends to over-weight them, although all are fairly rare in a population sense.

• Violence and Injury. Three steps:

For each service area and for Dallas County, add the 2011 age-adjusted death rates for the injury-related causes of death (motor vehicle crashes, poisoning, falls, suicide and homicide)

and the age-specific seniors falls death rate (all of which are in units of deaths per 100,000), to get a single number. Calculate for each service area the percent deviation from the Dallas

County total, from -infinity to +infinity.

Then using the rate per 100,000 of ED visits for injuries, calculate for each service area the percent deviation from the Dallas County rate, from -infinity to +infinity.

Calculate the arithmetic mean of these two percent deviations. That is the Violence and Injury deviation for the chart. This might over-weight ED visits somewhat, but it is qualitatively

different from mortality.

• High Risk Sexual Behavior. Three steps:

For each service area and for Dallas County, add the 2011 incidence rates for three non-HIV STDs (Chlamydia, gonorrhea and syphilis), to get a single number in

units of cases per 100,000. Calculate for each service area the percent deviation from the Dallas County total, from -infinity to +infinity.

Then using the rate of new HIV diagnoses per 100,000, calculate for each service area the percent deviation from the Dallas County rate, from -infinity to +infinity.

Then using the rate of births to girls 15-17, per population of girls 15-17, calculate for each service area the percent deviation from the Dallas County rate, from -

infinity to +infinity.

Calculate the arithmetic mean of these three percent deviations. That is the High Risk Sexual Behavior deviation for the chart. This might under-weight syphilis

somewhat. Each category is given an the equal statistical weight (STDs, HIV and teen births), since they are qualitatively quite different we probably can’t resolve

that to everyone’s satisfaction.

• Access to Clinical Care. For each service area and for Dallas County, add the 2011 percent of people without health insurance and

rate of non-emergent ED user per 1000 population, then subtract the rate of primary care physicians per 100,000 population (since

higher is better for this measure), to get a single number. Calculate for each service area the percent deviation of this total from

the Dallas County total, from -infinity to +infinity. That deviation is the access to care deviation for the chart. Although these three

measures are in different units, the values were in the range of 5-130 (in different units), such that the contributions of each of the

three measures to the total was approximately equal.

• Quality of Clinical Care. There are 12 preventable hospitalization discharge rates for each service area, age-adjusted in units of

discharges per 100,000. Some are more common, such as bacterial pneumonia (in the range of 100-400 discharges per 100,000),

while some are more rare (around 5-10 per 100,000). So for each service area and for Dallas County, for each discharge category

calculate the percent deviation from the Dallas County rate. Calculate the arithmetic average of these 12 deviations, that deviation

is the quality of care deviation for the chart.

• Socioeconomic indicators. There are four socioeconomic indicators—percent age 65 or older, percent age birth to 14, percent of

adults age 25+ without a high school diploma, percent of the population below the federal poverty limit. For each service area and

for Dallas County, for each of these four indicators calculate the percent deviation from the Dallas County rate. Calculate the

arithmetic average of these four deviations, that deviation is the socioeconomic deviation for the chart.

47

Methods of calculating deviations from the

Dallas County mean for the preceding chart

Notes:

• Age Adjusted Death Rates: Death rates that control for the effects in

population age distributions. The centers for Disease Control and Prevention

established the standard population weights for direct age adjustments. The

need for age adjustment becomes particularly important when cause-specific

mortality is of interest. Unadjusted rates for chronic diseases (cardiovascular

diseases, cancers, or chronic lower respiratory diseases) may appear to be

higher for older populations when compared to a younger population. With

age-adjustment those differences may be reduced or even reversed. A

mechanism for adjusting the age structure differences is needed to determine

if there really are mortality differences between two populations. By applying

age-specific mortality rates to a standard population, direct standardization

controls for differences in population composition. Mortality trends can be

more accurately compared along geographic, temporal, or race/ethnicity lines,

etc. In short, standardization lets us look at what the death rate would be in

one population if that population had the same age structure as the standard

population. Beginning with 1999 events, the United States year 2000

population is used as the standard for age-adjusting.

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